What eqiupment can I help my patient obtain for in home use? Who do I contact for this?

You can pretty much get any DME. The patient must meet what’s call Medical Necessity. For example limited mobility from MS or arthritis you can get a hospital bed and or a wheelchair. Of course home PT would would be ordered, but that’s not a cure, it will help but eventually those types of conditions worsen. Health Plans have their criteria, but they tend to follow CMS guidelines.

I don't mean to be rude or condescending but if you are asking this question while working in this role I don't think you need to be a case manager.

Social Worker primarily but you can ask Case Manager as well.

A physician or therapist usually determines what's needed prior to discharge. You've already heard what to do with patients with insurance. There are agencies that provide equipment for patients without insurance usually for no charge. There is a Goodwill Easter seal Warehouse in our area that provides no cost DME equipment and supplies for patients without insurance. You might check with your local County. These supplies are usually donated by family members of patients who no longer need equipment or who have deceased

What is the patients condition: has the patient had home health care or physical therapy: both of those can order DME. If you want to order DME, you need to go thru the patients insurance to see what company and what supplies to order.To order DME you need a physicians order to justify the supplies.

Medically necessary equipment may often be part of that patients health care benefits , This needs to be justified in the patients medical records and requested by the attending provider or PCP

What is needed and authorized depends on the area of specialty, Pediatrics, Geriatrics, Veterans.

As Nurse Glenda stated, CMS Guidelines take the lead for regulation of standards of care.

Following retrieved from CMS.gov:
“The Centers for Medicare & Medicaid Services, CMS, is part of the Department of Health and Human Services (HHS)”

Each of the aforementioned specialty areas has its own payor source.
You will with each client need to verify their insurance coverage.
They will have a customer service contact # listed on back of private insurance cards.
Always make sure and required
preauthorization is done so as to ensure payment and avoidance of client receiving a huge bill.
Per my limited parallel association with Pediatrics , many clients were in need of DME that is provided by the Medicaid Program.

Clients may need hospital beds, oxygen, wheelchairs, feeding, & foley supplies (for ex. G tube feeding supplies such as pump, tubing, pole, syringes) etc.

For home oxygen, for adults, they have to have oxygen saturation of 88% on room air, I do not know the criteria for Pediatric clients. And Of course they review need to avoid smoking in home with O2.

Wound care supplies may be needed. What is covered and what quantity depends on payor source.
In the past Home Health Companies supplied this along with the skilled nurses to perform and teach performance of site or wound care to the client or caregivers, as with IV Therapy.

Adults may also be Medicaid clients. In those cases the home health company had to get preauthorization for visits into the home and any equipment needed.

As the other nurse also mentioned, home eval per PT & OT can be a vital asset.
OT will generally focus on ADL related needs. Any item/equipment needed to increase the client’s independence with self care, feeding, toileting, as well as UE DME needs.
PT will evaluate for mobility equipment such as wheelchair walker canes etc.
What I love about home PT & OT evaluations is that they are “real time,” “real world,” done in the environment in which the client resides so DME can be appropriately matched for need as well as the environment.

VA: “CONSULT” is the word. They supply DME internally.
Motorized wheel chairs, FYI, require PMRS (Therapy) Evaluation. You can consider VA Consults to be the equivalent to preauthorization required by Civilian Private Insurance.

I’ve found that the simple yet subtly comprehensive questions below help me gather a tremendous amount about needs.

I want to talk to you and your family, caregiver about…
Where you live?
How you live?
What you have?
What you need?

It jump starts them telling you about their home life and how well they can take care of themselves or their loved ones and what DME and or other service may be an asset in the home.🤓